Public policy around senior housing - the good, the bad and the gaps

Public policy is so
interesting. Having spent time in
both local and state government, I can attest to the depth of the policy
discussions and the thoughtfulness that goes into each decision. However, as I sit outside of government
right now, I puzzle at how any level of government can keep the complete
picture—meaning the impact on other levels of government or even “silos” within
that level—in focus.

Last week, JCHE was pleased
to have the opportunity to comment on the 2011 Qualified Allocation Plan (QAP)
for the state’s Department of Housing and Community Development, the road map
for the state’s allocation of federal tax credits. I am very familiar with the QAP process, as I served as an Associate
Director for Public Housing and Rental Assistance at DHCD directly before
starting at JCHE. But as I
read it this year, I quickly realized that I was evaluating it through a very
different lens.

The
state allocates federal tax credits, which are needed these days to build and
preserve affordable housing. The
state weights the selection criteria to favor family housing over senior
housing. Given the state’s
responsibility to shelter families who find themselves homeless, this is a
natural, fiscally-responsible response.
Senior supportive housing, however, goes a long way towards enabling
folks to avoid nursing homes—and when the population that lives in affordable
senior housing goes to a nursing home, the federal government picks up the tab
at roughly ten times the cost of supporting that same person in housing. Yet the state only sees a fraction of
the savings—and as the allocating agency, they focus on the state budget
impacts first and foremost.

Furthermore,
HUD has announced its intention to reform the Section 202 program—which
heretofore provides capital and operating support for senior housing—to rely
more on tax credits and other sources of funds. Their plan depends on states deciding to allocate tax
credits to senior housing, yet the incentives remain there for family
housing.

Every day in my new role, I
witness the extensiveness of the need for affordable, supportive senior housing
and the enormous success that JCHE has in transforming lives. A few points to consider:

The aging of the
population will hit us like a demographic tsunami. Between the years 2000 and 2025, the number of seniors over
85 is expected to double. We can
count on the fact that this will be a frail population. We are not ready. The first of the baby boomers turned 65
this year—the wave is upon us!

The senior population
struggles to pay medical bills, food costs and housing. The U.S. Census Bureau calculates that
at 16%, the proportion of seniors living in poverty is higher than the
proportion of all Americans.

Seniors carry a heavy rent
burden. The DHCD-commissioned
study by the UMASS Donahue Institute showed that 53.5% of people over 75
experienced a housing cost burden—more than half—and the HIGHEST percentage for
any age group!

According to the Massachusetts
Secretary of the Executive Office of Elder Affairs, nearly all of the expected population growth in the
coming decade in our state will be senior citizens.

Senior supportive housing
is an efficient use of government dollars, compared to nursing home costs. At JCHE, fewer than 3% of our 1,300
residents move to nursing homes annually, despite the fact that our average age
is in the 80’s and that the average tenure is 10 years. For our residents who are
Medicaid-eligible, we conservatively estimate that the combined cost of the
supportive services plus the cost of housing at JCHE is $26 million less
annually than nursing home care.

There are few alternative
choices. Seniors in their 80’s
can’t simply get another job to earn a few more dollars and many can’t continue
to live in non-accessible housing.
The private 55+ communities are not addressing the needs of this
population. We must provide good options.

But all the numbers and statistics aside, there is
a very human element to be considered.
There are compelling reasons for seniors to live in housing like JCHE
provides, and we need to make it available to a broader number of people. Most significantly, seniors in our
housing feel safe. Our residents also do not feel isolated, a key challenge as
increased physical frailty limits mobility. The Commonwealth has been encouraging seniors to stop
driving and without well-located and staffed housing, that is less likely. For our residents, there is always a
neighbor around and “going out” can mean going downstairs for one of our many
activities. We also provide
transportation to shopping and to sites where our seniors volunteer. And we
have skilled staff to help navigate systems like social security and health
insurance that can cause frustration for many of our residents, and even terror
for those who are not English-speakers.

Very importantly, our residents are not burdened by
fears that their rents will soar beyond affordability. This is an enormous relief. Their children don’t need to fear that
their parent is alone and without support while they are at work or caring for
children of their own.

Historically, there has been a preference for
directing state funds to the needs of families. But the demographic realities we are now
facing in the Commonwealth cause us to take note. From where I now sit, I fully recognize the urgency with
which we need to re-think our priorities.